How does this medication work? What will it do for me?

Indomethacin belongs to the class of medications known as nonsteroidal anti-inflammatories (NSAIDs). It works by reducing pain, swelling, and inflammation. Indomethacin is used for the relief of pain accompanied by inflammation. It can be used for people with conditions such as rheumatoid arthritis, osteoarthritis, ankylosing spondylitis, degenerative hip disease, and gout. It does not prevent the progression of arthritis.

This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.

What form(s) does this medication come in?

Pro-Indo is no longer being manufactured for sale in Canada. For brands that may still be available, search under indomethacin. This article is being kept available for reference purposes only. If you are using this medication, speak with your doctor or pharmacist for information about your treatment options.

How should I use this medication?

When used on a regular basis, the usual recommended adult starting dose of indomethacin capsules is 25 mg to 50 mg 2 or 3 times a day. Your doctor will gradually increase the dose until the best results are achieved with the least amount of side effects. The maximum recommended daily dose of indomethacin is 200 mg. To minimize the chance of developing serious side effects, use of indomethacin should be limited to the lowest effective dose for the shortest possible duration of time.

Indomethacin should always be taken with food or antacids to reduce stomach upset.

The recommended dose of indomethacin suppositories is 100 mg to 200 mg daily. Doses higher than 100 mg must be given in 2 divided doses.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are using the medication without consulting your doctor.

It is important to take this medication exactly as prescribed by your doctor. If you miss a dose, take it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store this medication at room temperature, protect it from light and moisture, and keep it out of the reach of children.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

Who should NOT take this medication?

Do not take indomethacin if you:

are or may be allergic to indomethacin or any ingredients of the medication

symptoms of a serious allergic reaction (e.g., hives, swelling of the face or throat, or difficulty breathing)

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Are there any other precautions or warnings for this medication?

Before you begin taking a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should take this medication.

Allergic reactions: If you have had a reaction to acetylsalicylic acid (ASA) or other NSAIDs (e.g., ibuprofen, ketoprofen, ketorolac) that included a runny nose, itchy skin rash, nasal polyps, or shortness of breath and wheezing, you should not take this medication. If you experience symptoms of a severe allergic reaction (e.g., hives; difficulty breathing; wheezing; swelling of the face, tongue, or throat), get immediate medical attention.

Aseptic meningitis: This medication can rarely cause symptoms of aseptic meningitis (inflammation or swelling of the membranes around the brain and spinal cord that is not caused by bacteria). If you have an autoimmune condition (e.g., systemic lupus erythematosus, mixed connective tissue disease), you are more at risk for developing this. If you experience symptoms such as stiff neck, severe headache, nausea, vomiting, fever, or changes in consciousness, stop taking this medication and get immediate medical attention.

Bladder problems: This medication may cause bladder pain, painful or difficult urination, or increased frequency of urination. If these symptoms occur without an explanation (e.g., infection), stop taking this medication and contact your doctor.

Blood clotting: This medication may reduce the ability of the blood to clot. If you are taking anticoagulants (e.g., warfarin, heparin) or have hemophilia or other blood disorders (e.g., low platelets), discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed. If you have a bleeding disorder, do not take this medication.

Drowsiness and reduced alertness: Headaches, sometimes combined with dizziness or lightheadedness, may occur during treatment with indomethacin. (These headaches usually occur early in the treatment.) Avoid operating motor vehicles and doing other activities that require alertness until you determine how this medication affects you.

Heart problems and stroke: Indomethacin may increase the risk of heart attacks, strokes, and high blood pressure, and may also make existing high blood pressure worse. As well, it can cause fluid buildup, especially in the feet and legs.

If you have or have had a heart condition (such as congestive heart failure), high blood pressure, high cholesterol, stroke, kidney disease, or if you have had recent surgery, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

High blood potassium: There is a risk of high blood potassium with NSAID treatment. People most at risk are seniors, people with conditions such as diabetes or kidney failure, and people who are taking beta-adrenergic blockers, angiotensin converting enzyme (ACE) inhibitors, or some diuretics (water pills). Ask your doctor whether you need to have your potassium levels checked while you are taking this medication.

Kidney function: Long-term use of indomethacin may lead to a higher risk of reduced kidney function. This is most common for those who already have kidney disease, liver disease, or heart failure; for those who take diuretics (water pills); and for seniors. If you fit into one of these groups, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Liver function: Indomethacin may reduce liver function and can cause liver failure. If you have liver problems, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed. Your doctor may want to test your liver function regularly with blood tests while you are taking this medication.

If you experience symptoms of liver problems such as fatigue, feeling unwell, loss of appetite, nausea, yellowing of the skin or whites of the eyes, dark urine, pale stools, abdominal pain or swelling, and itchy skin, contact your doctor immediately.

Stomach ulcers: Stomach ulcers, perforation, and bleeding from the stomach have been known to occur during therapy with indomethacin. These problems can happen even to people who have never had stomach problems before. These complications can occur at any time, and are sometimes severe enough to require immediate medical attention. The risk of ulcers and bleeding increase for people taking higher doses of NSAIDs for longer periods of time.

If you have ever had a stomach ulcer, bloody stools, diverticulosis or other conditions affecting the stomach or intestines (such as ulcerative colitis or Crohn's disease), discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Pregnancy: Do not use this medication if you are in the third trimester of pregnancy. For the first and second trimesters, this medication should not be used unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately.

This medication may reduce fertility. If you are trying to get pregnant or are having difficulty getting pregnant, you should not use this medication.

Breast-feeding: This medication passes into breast milk. If you are a breast-feeding mother and are taking indomethacin, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of using this medication have not been established for children.
Seniors: Seniors appear to have a higher risk of side effects. They should use the lowest effective dosage under close medical supervision.

What other drugs could interact with this medication?

There may be an interaction between indomethacin and any of the following:

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

stop taking one of the medications,

change one of the medications to another,

change how you are taking one or both of the medications, or

leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. In many cases, interactions are intended or are managed by close monitoring. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications that you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.